Mako Robotic Arm TKR WEEK TWO

Posted by saeternes @saeternes, Dec 10, 2019

Bandages came off and the stitches turned out to be the dis-solvable kind under the skin, so no removal necessary. Great to have that heavy ace bandage and pads off. Some numbness on outside of knee, some weeping from the stitches, but overall feels okay. First time for a more painful therapy as Alex pushed harder on both bending and straightening. Numbers are about 3-4 deg. off perfectly straight (so 96-7) and 105 for bending. He wants to get to 110 next week. and lose two for straightening getting me to 98-9). He said scar is about 2-3" shorter than for traditional TKR. He warned me not to be obsessed with numbers or treat it like a competition as there are so many variables, including how much meds are in action at the time of measurement. That explains why I didn't feel much pain at the start when bending (shortly after surgery), as I was on heavy meds. I'm starting stationary bike today and Alex also again showed me how to walk correctly and not favor the knee. Alex and the dr. told me to keep taking meds if I need them to do the exercises so I will do that.

Mako for partial knee replacement has been around since 2006, but for full TKR only approved by FDA since 2017, so no long term studies are available yet. There are a few short term studies that show faster recovery and less pain, but at the one-year point, little real difference. For the 10-20 year studies (durability, complications) we'll have to wait.

Now I can take a shower!

I think I put that wrong – for straightening I'm at 3-4 degrees.

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@saeternes: Thanks for the progress report. Sounds like you are steadily improving. Now that the bulky bandage is gone, it should become easier to bend the knee. That first shower must have felt great! Numbness is to be expected, ought to gradually fade. One of my PT’s mentioned that some people are left with a permanent dead spot ranging from pencil eraser size to quarter size. More of a nuisance than a problem. And when you said Alex pushed, I’m sure you meant that figuratively, not him actually manhandling you!
Re. scar: I’m not really aware of my scar anymore (can’t say that for the knee, though – it still feels foreign), but I decided to really look at it today, and decided to measure it. Leg fully extended on floor is 3 3/4”, bent to the max (I have a lot of bend), it is 6 1/4”. Initially I massaged the scar twice a day with bio oil, but after about 7 months that routine got tired, and I gave up. It did not seem to make a huge difference in the appearance of the scar itself, and at age 70 I don’t go around in public with shorts or mini-skirts anymore.
Keep up the good work!

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@ellerbracke sounds like you had a very good surgeon with such a small scar. I think it also depends on the condition of the knee. Alex also has me moving the kneecap around up and down and back and forth so it will not get stuck. I've basically accepted the fact that therapy is now full time…no, he did not manhandle me but he did force a very uncomfortable bend and held it for 30 seconds, I was groaning. Now I am taking 5mgs of meds four times a day, don't need to wake up at night to take anymore but still need them for the exercises. Onward!

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I'm wondering if anyone switched from ice to heat for the knee somewhere along the way? They suggested that at the hospital but I haven't yet done it.

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Today, Day 16, has felt like a big improvement. I did more elevating and that helped a lot with the swelling, which in turn allowed for better movement. I can now do the sitting leg lift around 12" and other exercises are not as difficult. I am also massaging my leg and knee which seems to help. I feel much more stable on my feet and other than a pang now and then, don't feel much pain. Therapy is tomorrow so that will undoubtedly change.

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@ellerbracke

@saeternes: Thanks for the progress report. Sounds like you are steadily improving. Now that the bulky bandage is gone, it should become easier to bend the knee. That first shower must have felt great! Numbness is to be expected, ought to gradually fade. One of my PT’s mentioned that some people are left with a permanent dead spot ranging from pencil eraser size to quarter size. More of a nuisance than a problem. And when you said Alex pushed, I’m sure you meant that figuratively, not him actually manhandling you!
Re. scar: I’m not really aware of my scar anymore (can’t say that for the knee, though – it still feels foreign), but I decided to really look at it today, and decided to measure it. Leg fully extended on floor is 3 3/4”, bent to the max (I have a lot of bend), it is 6 1/4”. Initially I massaged the scar twice a day with bio oil, but after about 7 months that routine got tired, and I gave up. It did not seem to make a huge difference in the appearance of the scar itself, and at age 70 I don’t go around in public with shorts or mini-skirts anymore.
Keep up the good work!

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@ellerbracke @saeternes I just measured my scar and it's only about 4" long! Is that even possible? It's so hard to see it that I may have missed part of it, but I tried to make sure I saw the whole thing.
I never put anything on my scar or massaged it and the incision is almost invisible! My other scar is a bit longer but also almost invisible too so it just must be the way my pale skin heals. Scars tend to be white and my skin is very white.
JK

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@contentandwell that's a tiny scar, I don't know if some of it disappears over time or not, but you can check out pics on the web and I think you will see how small it is! I had therapy today, Day 17, and in addition to straightening (2 deg) and bending (112 deg) Alex did a lot of lymphatic massage, which is very gentle massage starting at the foot and moving upward, to encourage the system to absorb fluid and the swelling to go down. He wants me to have this done daily and thinks that the reduction in swelling will go a long way toward improving the actions of the knee.

I started the stationary recumbent bike a few days ago and can just get around with my foot touching the pedals. I can only last about 4 min before I am exhausted (not from aerobics, from the effect on the leg), so I get off and elevate, then do another four minutes. I am supposed to add half a minute a day if I can.

I now feel like the worst is over, even though I am far from completely rehabilitated. I will be trying to lower the dose of meds and get off completely; today therapy was not as painful as last time, and if I can reduce swelling, it should become less painful, i.e. fewer drugs.

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@saeternes

@contentandwell that's a tiny scar, I don't know if some of it disappears over time or not, but you can check out pics on the web and I think you will see how small it is! I had therapy today, Day 17, and in addition to straightening (2 deg) and bending (112 deg) Alex did a lot of lymphatic massage, which is very gentle massage starting at the foot and moving upward, to encourage the system to absorb fluid and the swelling to go down. He wants me to have this done daily and thinks that the reduction in swelling will go a long way toward improving the actions of the knee.

I started the stationary recumbent bike a few days ago and can just get around with my foot touching the pedals. I can only last about 4 min before I am exhausted (not from aerobics, from the effect on the leg), so I get off and elevate, then do another four minutes. I am supposed to add half a minute a day if I can.

I now feel like the worst is over, even though I am far from completely rehabilitated. I will be trying to lower the dose of meds and get off completely; today therapy was not as painful as last time, and if I can reduce swelling, it should become less painful, i.e. fewer drugs.

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@saeternes I've been occupied for a few days. How is your knee doing? I think I am going to have to have my husband check out my scar and maybe take a picture of it with a ruler next to it. I suspect it's just that on the end it blends in with my skin. As you say, that would be a very tiny scar for a knee replacement.
Your PT sounds great. I'm jealous!
JK

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@contentandwell things are going pretty well, I started a new thread when I reached the 3 week point. I'm at 116 and 2 at exactly 3 weeks. I do very much like my PT. He's having me do regular stair walking now (like a normal person) and I can do it slowly. The scar is healing and it just has one scab left at the bottom waiting to fall off. Most interesting and effective has been the lymphatic massage, which has really gotten the swelling down. I can actually see the bones in my ankle and foot! It doesn't look much different from the other leg although of course there is still some swelling in the knee itself. Thanks for your concern.

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@saeternes

@contentandwell things are going pretty well, I started a new thread when I reached the 3 week point. I'm at 116 and 2 at exactly 3 weeks. I do very much like my PT. He's having me do regular stair walking now (like a normal person) and I can do it slowly. The scar is healing and it just has one scab left at the bottom waiting to fall off. Most interesting and effective has been the lymphatic massage, which has really gotten the swelling down. I can actually see the bones in my ankle and foot! It doesn't look much different from the other leg although of course there is still some swelling in the knee itself. Thanks for your concern.

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@saeternes Since my femur fracture in July I have really regressed and have gotten into the habit of taking the stairs one at a time, but am trying to remind myself to go up normally. My thigh still hurts though.
No one ever massaged my knee! I wish that was something my PT did do. That sounds really great.
Sounds like you have been doing very well. I have been remiss in my responses due to many family holiday obligations and my son and daughter, and their spouses visiting. All are gone now.
JK

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@contentandwell sorry to hear about the regression after fracture – but I can imagine it would be very hard. I'm now at 5 weeks and at the 6 week point will post a new thread with my observations. The lymphatic massage isn't just for the knee, but for the foot and entire lower leg and knee. It is very soft, as if brushing the skin. I understand about being remiss -because therapy takes all your time and energy and I find with even one thing scheduled, I don't get as much exercise in. Tomorrow I'll return to the Y to lift weights so we'll see how that goes. Best of wishes for the New Year!

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@saeternes

@contentandwell sorry to hear about the regression after fracture – but I can imagine it would be very hard. I'm now at 5 weeks and at the 6 week point will post a new thread with my observations. The lymphatic massage isn't just for the knee, but for the foot and entire lower leg and knee. It is very soft, as if brushing the skin. I understand about being remiss -because therapy takes all your time and energy and I find with even one thing scheduled, I don't get as much exercise in. Tomorrow I'll return to the Y to lift weights so we'll see how that goes. Best of wishes for the New Year!

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Thanks @saeternes Best wishes to you too. I always find it difficult to get exercise in at home which is why I prefer going to my health club. Once there I get the exercise I need.
JK

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